Provider Demographics
NPI:1912171505
Name:THAYER, LISA ORSINI (PHD)
Entity type:Individual
Prefix:DR
First Name:LISA
Middle Name:ORSINI
Last Name:THAYER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 FEATHERBED LN
Mailing Address - Street 2:
Mailing Address - City:HOPEWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:08525-1104
Mailing Address - Country:US
Mailing Address - Phone:973-876-1274
Mailing Address - Fax:510-509-9985
Practice Address - Street 1:110 FEATHERBED LN
Practice Address - Street 2:
Practice Address - City:HOPEWELL
Practice Address - State:NJ
Practice Address - Zip Code:08525-1104
Practice Address - Country:US
Practice Address - Phone:973-876-1274
Practice Address - Fax:510-509-9985
Is Sole Proprietor?:No
Enumeration Date:2008-04-15
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017401103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No103T00000XBehavioral Health & Social Service ProvidersPsychologist